myelinolysis

Myelinolysis refers to the breakdown or destruction of myelin, the fatty insulating sheath that surrounds nerve fibers (axons) in the central nervous system. This protective covering is crucial for efficient and rapid transmission of nerve impulses. When myelin is damaged, nerve signal conduction is impaired, leading to a variety of neurological symptoms.

The most common and well-known form of myelinolysis is central pontine myelinolysis (CPM), which specifically affects the pons, a part of the brainstem. CPM is often associated with rapid correction of hyponatremia, a condition of low sodium levels in the blood. Other forms of myelinolysis can affect different areas of the brain, such as extrapontine myelinolysis (EPM), which can involve the basal ganglia, thalamus, or cerebellum.

The causes of myelinolysis are varied but often relate to metabolic disturbances. Besides electrolyte imbalances like hyponatremia, alcohol abuse, malnutrition, and certain medical conditions can also contribute to myelin damage. Symptoms depend on the location and extent of myelin loss and can range from weakness and paralysis to speech difficulties, cognitive impairment, and changes in consciousness. Diagnosis typically involves neuroimaging techniques like MRI. Treatment focuses on addressing the underlying cause and supportive care.